557. Improving Surgical Antimicrobial Stewardship with Quarterly Audit and Feedback Scorecards

Abstract Background Adherence to national surgical antimicrobial prophylaxis (SAP) is of utmost importance to prevent antimicrobial resistance. Guideline development does not always confer compliance with changes. This report describes an ongoing process of quarterly SAP audit and feedback using individualized scorecards. Methods Our hospital participates in local data collection for the National Surgery Quality Improvement Program- Pediatric (NSQIP-P). We implemented changes to local SAP guidance to better align with national recommendations and collected data regarding baseline SAP beginning in January 2019. Using these data, we initiated an audit and feedback program of quarterly scorecard reports beginning in January 2020 regarding surgical adherence to national SAP guidelines at our children’s hospital. This scorecard gives each surgeon a quarterly, private, individual report, allowing them to review cases that deviated from SAP guidance, and compare their scores to the surgical team as a whole. NSQIP-P cases are adjudicated manually for SAP adherence. The program aimed to improve adherence to SAP guidance, promote collaborative discussion, and identify areas for improvement in prescribing practices and local guidelines. The goal was to reach >90% compliance with SAP guidance. Results Baseline adherence to SAP guidance was 50-85%. After introducing the audit and feedback program in January 2020, SAP compliance rates increased overall. In the most recent 3 quarters (2021 Q1-3), adherence was 95%, 89%, and 95%, respectively. Figure 1.Antimicrobial stewardship report by quarter among the pediatric surgery teamFigure 2.Example of individual audit & feedback scorecard Conclusion We have seen an improvement overall in SAP compliance and have reached the goal of >90% compliance. One drawback to this program is the need for manual case review. Feedback using scorecards has led to better communication regarding process changes for SAP prescribing. Disclosures All Authors: No reported disclosures.